This article on the need to shift away from food bank statistics for discussing food insecurity was written for Upstream‘s series focused on food insecurity in Canada. Read their introductory article on this serious public health issue and see the rest of the articles in the series.

‘Food insecurity’ refers to the inadequate access to food because of financial constraints — and it’s a larger problem in Canada than most realize.

Since 1997 Food Banks Canada has released annual reports called ‘Hunger Count’ documenting the food bank usage. These reports have received wide media attention and are now a common point of reference when we discuss Canadian food insecurity, but they barely scratch the surface of the problem.

Food bank stats significantly understate the prevalence of food insecurity. We know this because Statistics Canada has been monitoring the problem nationally for almost a decade through the Canadian Community Health Survey (CCHS). With its rigorous methods and large sample size this survey provides reliable health data at the provincial, territorial and national levels. It reveals more than four million Canadians were food insecure in 2012 — the most recent national estimate we have.

Food Banks Canada surveys its members every March to estimate use. In 2012 they estimated that only 882,188 people used food banks that month. The stark difference between the results of the CCHS and Food Banks Canada shows there’s a much larger problem than we’ve understood. Food insecurity in Canada is a national crisis.

Food bank stats also fail to capture changes in food insecurity over time. While the Hunger Count report draws attention to annual differences in food bank use in each province, food bank use actually appears relatively stable over time in comparison to the trends in food insecurity revealed by population stats. From 2007 to 2011 for example, we saw a steady decline in food insecurity in Newfoundland and Labrador, and a steady increase in Nova Scotia. But neither trend could be seen in food bank statistics.

“Many felt visiting a food bank wasn’t something a ‘person like them’ they should be doing.”

Our research group’s study on low income families in Toronto found almost all of those surveyed experienced food insecurity, yet only 23 percent actually used food banks. When we asked ‘why?’ it became clear there was a disconnect between how families thought about their actual needs, and what services the food banks were offering.

Many felt visiting a food bank wasn’t something a ‘person like them’ they should be doing, or something that could help them out of their situation. By the time families are food insecure they face much more than a lack of food. They are likely behind on bill payments, rent and other basic necessities. If they are also dealing with chronic illness, they may be foregoing critical expenses like medication too.

Turning to a food bank for help was an act of desperation. But even with this assistance, most families remained food insecure. This finding is consistent with other research in Canada — showing it takes substantial improvements to a household’s financial circumstances, to shift them out of food insecurity.

Food bank stats are a poor barometer of food insecurity because they don’t describe the size of the problem or how it’s changing over time. On the other hand the CCHS allows us to accurately measure the extent of food insecurity and systemically investigate its causes and consequences. Since we began monitoring, we’ve learned food insecurity is a serious public health issue that impacts physical, mental and social health — and healthcare costs, too.

“Even with this assistance, most families remained food insecure.”

We also have a growing body of evidence showing the prevalence of food insecurity is responsive to changes in social policies. Yet there have been no public policies introduced so far, with the explicit goal of reducing food insecurity. We must shift the conversation from food banks toward insights from population stats, and upstream approaches to address food insecurity in Canada.

Food insecurity, also known as ‘food poverty,’ can cause significant anxiety over diminishing household food supplies and result in individuals modifying their eating patterns — adults skipping meals so children can eat or sacrificing quality food choices for cheaper, less healthy options, for example. Food insecurity also often results in physical hunger pangs, fatigue and lack of concentration and productivity at school, work or play.

Then there are the social impacts of food insecurity that most of us wouldn’t consider, such as not being able to invite friends and family to dinner or being unable to afford to meet people for coffee. Food poverty can also create stress and conflict in family relationships and meals are often not a happy gathering opportunity.

Evidence also shows the health impact of food insecurity exists on a gradient – meaning adults in more severely food-insecure households are more likely to report chronic health conditions as well as receive diagnoses of multiple health conditions.

A study in Ontario found that among adults, total healthcare costs — including inpatient hospital care, emergency department visits, physician services, same-day surgeries and home care services — increase significantly with the level of household food insecurity.

In other words, food insecurity costs us all through increased healthcare use. Compared with adults in food-secure households, annual healthcare costs were, on average 16 per cent (or $235) higher for adults in households with marginal food insecurity, 32 per cent (or $455) higher among those with moderate food insecurity and 76 per cent (or $1092) higher among those with severe food insecurity.

Food Banks Canada recently estimated food bank use for a twelve month period at 1.7 million people, yet the number of food insecure individuals living in Canada is more than double this estimate. The main reason for this discrepancy is that most people struggling to afford the food they need do not turn to charities for help. The evidence suggests that using food banks is a last resort. Because food banks rely on donated food, both the amount and type of food available for distribution is limited, and agencies are unable to provide for everyone in need.

4. An adequate and secure level of household income is strongly linked to food security

It is perhaps surprising, but households reliant on wages and salaries make up the majority of food insecure households in Canada at 62 per cent. Households whose main source of income was either pensions or dividends and interest had the lowest rate of food insecurity in 2012 at seven per cent — compared to 11 per cent for people in the workforce and 70 per cent for people on social assistance (i.e., welfare and disability support programs). Researchers suggest the low rate of food insecurity among Canadian seniors reflects the protective effects of our public pension system.

5. Relatively modest increases in income have been found to lessen food insecurity among low-income families

Studies have shown that improved incomes and changes in employment can reduce food insecurity. An example of this can be found in Newfoundland and Labrador where evidence shows that from 2007 to 2012 the rate of food insecurity among households living on social assistance in this province fell from a staggering 60 per cent to 34 per cent. During this time period, the Newfoundland government made several changes to improve the circumstances of people living on social assistance, including increasing benefit levels and indexing them to inflation (until 2012).

Let’s not let another year go by without addressing food insecurity in Canada. In a country as rich as ours, there’s no reason anyone should go hungry.

This study investigated the prevalence of household food insecurity in census metropolitan areas and the effect of various local economic factors on changes in these rates. Examining data from the 2007-2012 Canadian Community Health Survey, the researchers found peak unemployment rates to be associated with the prevalence of food insecurity. These results ​support a growing literature that identifies employment conditions as central problem​s​ ​of food insecurity ​and suggest that policy initiatives to improve these conditions ​could reduce food insecurity.

View coverage from a press conference held to share PROOF findings on food insecurity in Newfoundland and Labrador that were presented at the Canadian Nutrition Society (CNS-SCN) 2014 Conference in St. John’s, Newfoundland and Labrador on Saturday, June 7, 2014.